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New Hampshire rates for HCPCS 21089

Unlisted maxillofacial prosthetic procedure

Facilitymedian $2,291 · 10th–90th $1,349–$4,3650%20%10th90th$2,291Professionalmedian $1,047 · 10th–90th $1,047–$1,0470%50%100%$1,047$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,412.54 / $3,467.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,801.89 / $4,897.79